Provider Demographics
NPI:1295273472
Name:NJENGA, PETER J (RN)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:J
Last Name:NJENGA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:PETER
Other - Middle Name:J
Other - Last Name:NJENGA NGIGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:8708 ZIRCON DR SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498-4047
Mailing Address - Country:US
Mailing Address - Phone:253-334-0716
Mailing Address - Fax:253-584-1532
Practice Address - Street 1:8708 ZIRCON DR SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98498-4047
Practice Address - Country:US
Practice Address - Phone:253-334-0716
Practice Address - Fax:253-584-1532
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60431281163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse